Abstract
PURPOSE The patient-physician relationship is the cornerstone of health care service delivery. The objectives of this study were to assess the contribution of relationship commitment along with trust to patient-physician relationships and to evaluate the association of commitment and trust with adherence to medical advice and healthy eating behaviors.
METHODS To test the proposed model, we developed a questionnaire that included both existing scales and a scale constructed specifically for the study; the questions addressed trust, commitment, adherence to physicians’ medical recommendations, and healthy eating behavior. The questionnaire was given to adult patients in the waiting rooms of 4 large clinics in central Texas.
RESULTS A total of 1,008 patients returned questionnaires; 869 patients’ questionnaires were complete and used in the analysis. A 3-stage least squares analysis that tested a system of 4 equations which included relationship commitment yielded a systemwide R2 of 0.71 that was 0.09 higher than a system of equations excluding relationship commitment. Trust and commitment were positively associated with adherence (P <.001 and P = .02, respectively). We also found positive relationships between adherence and commitment and between trust and commitment (P <.001 for each). Adherence and commitment were both associated with healthy eating behavior as well (P <.001 for each).
CONCLUSIONS Patients’ trust in their physician and commitment to the relationship offer a more complete understanding of the patient-physician relationship. In addition, trust and commitment favorably influence patients’ health behaviors.
- Physician-patient relations
- relationship commitment
- trust
- physician behavior
- patient adherence
- patient compliance
- healthy eating behavior
- primary care
- Received for publication January 26, 2007.
- Revision received July 13, 2007.
- Accepted for publication July 31, 2007.
- © 2008 Annals of Family Medicine, Inc.